Claims Optimization

Claims Data Management and Analysis

Cutting through the clutter
Getting real business intelligence from claims data is tough. Think volumes of data, thousands of providers, millions of members. Sorting through it to find trends and patterns would be too time consuming.

By using freely-available right tools, your business can direct investments towards activities that yield real understanding. Our solutions on claims data analysis is easy-to-run management reporting, assessing claims processing across different member demographics, provider specialties and groups. Drillable OLAP cubes of claims promote deeper insight, allowing business analysts to identify trends across the different dimensions of members, groups and providers. Sure there’s a lot of data, but OpenBI’s solutions help you sort and access the answers you need to move ahead clearly.

Benefits:

• Find out what services members are using and how best to define reimbursement policies
• Develop new, data-driven plan concepts for groups that will help their members use the service plans in the best way possible
• Determine which providers are falling inside or outside of expected norms, so you can take the appropriate action
• Identify reimbursement patterns to see how claims are being paid, and identify problems in payment processing

Claims Data Integration and Consolidation

A clear strategy
Too often, claims data is spread across multiple systems and processes and is organized for transaction handling, not for analysis. OpenBI’s extensive experience with claims data gives us insight on how to bring it all together, all under a cost-effective, open source infrastructure.

Whether you’re looking at policies, members, groups or providers, OpenBI has intimate experience with the nuances of this data, as well as deep knowledge about organizing it for maximum utility. If you’re looking for a data-driven approach to understanding and optimizing claims performance, start with a clear strategy and our open source based data management infrastructure.

Benefits:

• Accelerate new analysis and reporting projects with a consolidated view of claims data across the organization
• Reduce the cost of your data management infrastructure with open source technologies powering your database
• Lower the complexity and time of data modeling with our proven approach to claims data
• Gain new insights into claims data, and provision the data across the organization with advance web-service drive deployments of key claim data